Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review

Woodworth, Michael H.; Carpentieri, Cynthia; Sitchenko, Kaitlin L.; Kraft, Colleen S.

doi:10.1080/19490976.2017.1286006

Cited by 93 publications

(77 citation statements)

References 64 publications

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“…This applies, for example, to screening for the presence of multi-drug-resistant (MDR) organisms, including ESBL-and carbapenemase-producing bacteria, vancomycin-resistant enterococci, and methicillinresistant Staphylococcus aureus. Screening for the (asymptomatic) presence of rotavirus is not routinely performed by stool banks, but as rotavirus is often found in asymptomatic donors, especially in winter, we included this in our protocol [26,28]. Adenovirus type 40/41, Sapovirus and Astrovirus are associated with mild gastrointestinal diarrhoea and are therefore also screened [29].…”

Section: Donor Screening By Laboratory Testsmentioning

confidence: 99%

How to: Establish and run a stool bank

Terveer

Beurden

Goorhuis

et al. 2017

Clinical Microbiology and Infection

141

144

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Section: Donor Screening By Laboratory Testsmentioning

confidence: 99%

How to: Establish and run a stool bank

Terveer

Beurden

Goorhuis

et al. 2017

Clinical Microbiology and Infection

141

144

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“…2,8 Fecal microbiota transplantation (FMT) is a highly effective therapy for patients with recurrent C. difficile infection, with a greater than 90% success rate. [9][10][11][12] Emerging evidence suggests that FMT may also have therapeutic benefits in other conditions associated with perturbed gut microbiota, including ulcerative colitis, [13][14][15][16] Crohn's disease, 17 irritable bowel syndrome, 18 metabolic syndrome, 19,20 multiple sclerosis, 21,22 depression, 23 and autism. 24,25 Intense interest in FMT is evident, with over 250 clinical trials registered on of January 11, 2019.…”

Section: Introductionmentioning

confidence: 99%

In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation

et al. 2019

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Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridioides difficile infection. Stool donors are essential, but difficult to recruit and retain. We aimed to identify factors influencing willingness to donate stool. This multi-center study with a 32-item questionnaire targeted young adults and health care workers via social media and university email lists in Edmonton and Kingston, Canada; London and Nottingham, England; and Indianapolis and Boston, USA. Items included baseline demographics and FMT knowledge and perception. Investigated motivators and deterrents included economic compensation, screening process, time commitment, and stool donation logistics. Logistic regression and linear regression models estimated associations of study variables with self-assessed willingness to donate stool. 802 respondents completed our questionnaire: 387 (48.3%) age 21-30 years, 573 (71.4%) female, 323 (40%) health care workers. Country of residence, age and occupation were not associated with willingness to donate stool. Factors increasing willingness to donate were: already a blood donor (OR 1.64), male, altruism, economic benefit, knowledge of how FMT can help patients (OR 1.32), and positive attitudes towards FMT (OR 1.39). Factors decreasing willingness to donate were: stool collection unpleasant (OR 0.92), screening process invasive (OR 0.92), higher stool donation frequency, negative social perception of stool, and logistics of collection/transporting feces. We conclude that 1) blood donors and males are more willing to consider stool donation; 2) altruism, economic compensation, and positive feedback are motivators; and 3) screening process, high donation frequency, logistics of collection/transporting feces, lack of public awareness, and negative social perception are deterrents. Considering these variables could maximize donor recruitment and retention. ARTICLE HISTORY

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“…In this regard, both a strict donor selection and an efficient donor recruitment practice are both central components, 7 but practical aspects challenge their implementation. 8 First, a screening program that minimizes the risk of transferring infectious and non-infectious diseases must be implemented. Detailed screening protocols have been published, 7 , 9-11 but the work required for their implementation is extensive; moreover, despite a scientific consensus for this vigorous screening, 12 , 13 the evidence supporting the screening protocols remains low.…”

Section: Introductionmentioning

confidence: 99%

Recruitment of feces donors among blood donors: Results from an observational cohort study

et al. 2018

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As the use of fecal microbiota transplantation (FMT) has gained momentum, an increasing need for continuous access to healthy feces donors has developed. Blood donors constitute a healthy subset of the general population and may serve as an appropriate group for recruitment. In this study, we investigated the suitability of blood donors as feces donors. In a prospective cohort study, we recruited blood donors onsite at a public Danish blood bank. Following their consent, the blood donors underwent a stepwise screening process: First, blood donors completed an electronic pre-screening questionnaire to rule out predisposing risk factors. Second, eligible blood donors had blood and fecal samples examined. Of 155 blood donors asked to participate, 137 (88%) completed the electronic pre-screening questionnaire, 16 declined, and 2 were excluded. Of the 137 donors who completed the questionnaire, 79 (58%) were excluded mainly due to having an allergy, being overweight, or presenting gastrointestinal complaints. Among the remaining 58 (37%) donors, complete blood and feces screenings were obtained from 46 (79%). Of these 46 donors, 15 (33%) were excluded primarily due to abnormal blood results or the presence of apathogenic intestinal parasites. Overall, 31 (20%; 95% confidence interval 14–27%) of the 155 blood donors qualified as feces donors. In conclusion, blood donors constitute a suitable and motivated population for a continuous recruitment of voluntary feces donors. We found that a stepwise recruitment procedure was feasible and that 20% of the blood donors were eligible for feces donation.

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Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review

Cited by 93 publications

References 64 publications

How to: Establish and run a stool bank

How to: Establish and run a stool bank

In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation

Recruitment of feces donors among blood donors: Results from an observational cohort study

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